至今中國總共有三間生物公司的疫苗踏入Phase3狀態，包括為Cansino、Sinovac及Sinopharm。802Please respect copyright.ＰＥＮＡＮＡBc2GdMl4Be
802Please respect copyright.ＰＥＮＡＮＡSYwyozmwFp
其中Sinovac (Phase 3地點:巴西）及國營的Sinopharm(Ref2) (Phase 3地點:阿聯酋）兩間均用上滅活病毒疫苗(Inactivated Virus Vaccine)設計，本文將會就此作深入探討。802Please respect copyright.ＰＥＮＡＮＡXSKIgKu1Kp
802Please respect copyright.ＰＥＮＡＮＡ1jBMiyAdqX
802Please respect copyright.ＰＥＮＡＮＡLGeHz2kgBf
（圖1）滅活病毒疫苗，顧名思義就是將病毒除去感染能力，當作疫苗之用。802Please respect copyright.ＰＥＮＡＮＡToCfXRspK8
802Please respect copyright.ＰＥＮＡＮＡphvtkcLZ0T
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)802Please respect copyright.ＰＥＮＡＮＡQQv6bqH3Px
802Please respect copyright.ＰＥＮＡＮＡtJjgj82nOz
1.從一名進入深切治療部的中國病患肺部體液中抽取病毒。802Please respect copyright.ＰＥＮＡＮＡPsUt95JHk3
802Please respect copyright.ＰＥＮＡＮＡKoGp0gKnwo
2.經過數輪實驗室細胞的培植，使病毒數量增加。802Please respect copyright.ＰＥＮＡＮＡ93oFxQJD5q
802Please respect copyright.ＰＥＮＡＮＡCDEBB0FvpP
3.加入化學物消減病毒的感染力和多重過濾，取得弱化的武肺病毒。802Please respect copyright.ＰＥＮＡＮＡa7WOgg9yiE
802Please respect copyright.ＰＥＮＡＮＡRH6NEyLLZU
4.將其製成可注射的疫苗。802Please respect copyright.ＰＥＮＡＮＡTdsIb3yh3g
802Please respect copyright.ＰＥＮＡＮＡ1l2zG3D2v4
802Please respect copyright.ＰＥＮＡＮＡKSacj9JgDe
802Please respect copyright.ＰＥＮＡＮＡm17cwQ0mgI
（圖2）將滅活病毒疫苗注射到身體後，身體的免疫細胞便會製作對應弱化病毒的抗體。802Please respect copyright.ＰＥＮＡＮＡYzYvrlZ1jc
802Please respect copyright.ＰＥＮＡＮＡRXzGjaM9WS
在繼續講述抗體之前，可先閱覽（圖3）溫故知新一下武肺入侵人體細胞的簡要過程，又或者可以到之前我所寫的文章觀看略為詳細的版本。802Please respect copyright.ＰＥＮＡＮＡI1k8RiKFX4
https://www.penana.com/article/466568802Please respect copyright.ＰＥＮＡＮＡqV4cW5abrz
802Please respect copyright.ＰＥＮＡＮＡecd5YHgvET
802Please respect copyright.ＰＥＮＡＮＡxYWGixNGZo
802Please respect copyright.ＰＥＮＡＮＡjKHT82tX6d
802Please respect copyright.ＰＥＮＡＮＡy1hl8loGnW
802Please respect copyright.ＰＥＮＡＮＡtbxfLzHjCS
802Please respect copyright.ＰＥＮＡＮＡLDG9DYK4zU
802Please respect copyright.ＰＥＮＡＮＡbYxb5VV69L
802Please respect copyright.ＰＥＮＡＮＡGDchzWaaeO
（圖4）抗體（Antibody)頂多只能阻礙病毒進入細胞或者指示其他免疫細胞前來清滅病毒，並無獨立能力清滅病毒。802Please respect copyright.ＰＥＮＡＮＡ9MtRCVk2qC
802Please respect copyright.ＰＥＮＡＮＡ4IRseTVV2T
而能夠阻礙病毒進入細胞的抗體，我們將稱之為Neutralizing Antibody，而圖中已列出其中的兩款機制。802Please respect copyright.ＰＥＮＡＮＡ8NHKH0pzCc
802Please respect copyright.ＰＥＮＡＮＡKKkVS1XgzE
1.抗體與病毒的S protein合併，802Please respect copyright.ＰＥＮＡＮＡB51gM06zNA
防止條件1的達成。802Please respect copyright.ＰＥＮＡＮＡLDOCCdScUN
802Please respect copyright.ＰＥＮＡＮＡgCdhh51asY
2.抗體與病毒其他位置合併，802Please respect copyright.ＰＥＮＡＮＡiGuRTQwmZh
防止條件3的達成。802Please respect copyright.ＰＥＮＡＮＡuaK6ofo5bB
802Please respect copyright.ＰＥＮＡＮＡyQkNBDd5Y1
802Please respect copyright.ＰＥＮＡＮＡhucGA7N3Qs
802Please respect copyright.ＰＥＮＡＮＡxmtkyC3rfw
（圖5）用上滅活病毒疫苗的話，抗體的製作便會針對病毒的各個位置而進行。802Please respect copyright.ＰＥＮＡＮＡGHldASW1y3
基於並非所有抗體也能夠拼合在病毒的關鍵位置，不能夠阻礙病毒進入細胞的抗體，我們將稱之為Non-Neutralizing Antibody。802Please respect copyright.ＰＥＮＡＮＡjdDAxQtMld
802Please respect copyright.ＰＥＮＡＮＡaInFCnN7T7
不過，就算是Non-Neutralizing Antibody，它亦能有能力標示病毒，指引其他免疫細胞前來清滅病毒。802Please respect copyright.ＰＥＮＡＮＡ5Ieq5HPMp2
802Please respect copyright.ＰＥＮＡＮＡZqW18CwG9P
802Please respect copyright.ＰＥＮＡＮＡMdf6yK9cFd
802Please respect copyright.ＰＥＮＡＮＡTy4VPYfu4O
802Please respect copyright.ＰＥＮＡＮＡgemy56iwri
（圖6）Non-Neutralizing Antibody的出現，將會引伸出一個名為Antibody Dependent Enhancement(ADE)的重要問題;802Please respect copyright.ＰＥＮＡＮＡ8tmH5fdZ6E
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。802Please respect copyright.ＰＥＮＡＮＡu0XKWttaHI
802Please respect copyright.ＰＥＮＡＮＡ9aA7EjYzPu
免疫細胞的表面上，有著接收器識辨抗體的某個區域。802Please respect copyright.ＰＥＮＡＮＡsck3uejhjN
802Please respect copyright.ＰＥＮＡＮＡeSuOSEOG2r
但若果有過多Non-Neutralizing Antibody黏在病毒裡頭的話，病毒就有機會可以無視之前那3條法則，不需要經過ACE2，而是透過免疫細胞的表面上識辨抗體的接收器進入細胞。802Please respect copyright.ＰＥＮＡＮＡaYKKVAY9vP
802Please respect copyright.ＰＥＮＡＮＡpxIMxo6RBH
換句話說，抗體在這情況下變相成為幫兇或者25仔，輔助病毒進入細胞，這現象我們稱之為ADE。802Please respect copyright.ＰＥＮＡＮＡTmusEVHFRb
802Please respect copyright.ＰＥＮＡＮＡpMpDMh1dof
802Please respect copyright.ＰＥＮＡＮＡGm6W95J4Of
802Please respect copyright.ＰＥＮＡＮＡ443qEOfx5m
（圖7）武肺病毒進入細胞後，需要切割S protein才能夠開始進行繁殖工作。802Please respect copyright.ＰＥＮＡＮＡf7VabGRdxk
所以就算有Non-Neutralizing antibody做25仔，如果病毒幸運地有Neutralizing antibody保護S protein免受切割的話，病毒依舊無法作惡。802Please respect copyright.ＰＥＮＡＮＡqGcOcidWIk
802Please respect copyright.ＰＥＮＡＮＡcApTxh51CN
但若果無Neutralizing antibody保護的話，病毒就會利用免疫細胞作為寄主，避開一切免疫機制，大量製造病毒。802Please respect copyright.ＰＥＮＡＮＡl2myM4jJQ9
情形就好像本身理應維護法紀的警察，突然之間搖身一變成為罪惡的溫床，窩藏及協助罪犯（病毒）滋生，導致情況一發不可收拾。802Please respect copyright.ＰＥＮＡＮＡzv3N8lvb9Z
802Please respect copyright.ＰＥＮＡＮＡyChZPuh6eV
802Please respect copyright.ＰＥＮＡＮＡDTIzxcgm17
802Please respect copyright.ＰＥＮＡＮＡ9WRKlbEU6R
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)802Please respect copyright.ＰＥＮＡＮＡk8wTvQfD5r
以登革熱為例，病人染上登革熱病毒(Dengue Virus)的話，身體便會製造登革熱病毒抗體。802Please respect copyright.ＰＥＮＡＮＡ4ZDAd3CNSu
但基於登革熱病毒與寨卡病毒(Zika Virus)有頗為相似的地方，某部份的登革熱病毒抗體「幸運地」便成為寨卡病毒的Non-Neutralizing Antibody，透過ADE幫忙寨卡病毒入侵人體。802Please respect copyright.ＰＥＮＡＮＡANLUUlQwQI
802Please respect copyright.ＰＥＮＡＮＡeTmDXT6rf4
亦即是說，擁有登革熱病毒抗體的人反而更有機會受到寨卡病毒入侵。802Please respect copyright.ＰＥＮＡＮＡWtypgJdNoT
802Please respect copyright.ＰＥＮＡＮＡ0w2CTEkbo0
802Please respect copyright.ＰＥＮＡＮＡKIM6swQa4f
802Please respect copyright.ＰＥＮＡＮＡa0WTerazuK
（圖9）有研究指出，03年SARS病毒亦會依靠未曾上市的疫苗所產生出的Non-Neutralizing Antibody，不需經過ACE2便能入侵免疫細胞。（Ref5)802Please respect copyright.ＰＥＮＡＮＡRWMx5Uyv5t
802Please respect copyright.ＰＥＮＡＮＡukNOWQ7gKd
武肺會否出現同樣現象，暫時尚未清楚。802Please respect copyright.ＰＥＮＡＮＡqnVIIkGjss
802Please respect copyright.ＰＥＮＡＮＡvhpYSxmNDF
只不過各國進行Phase3中的疫苗，大多也是針對著武肺病毒S protein位置而設計，故此出現Non-Neutralizing antibody將會比用上整個武肺病毒而作為疫苗設計的那兩間公司為低，ADE的機率亦相對減少。802Please respect copyright.ＰＥＮＡＮＡqZVEnPijPM
802Please respect copyright.ＰＥＮＡＮＡZIZtAKFZWx
當然，另一方面來看，中國那兩間公司因為用上整個武肺病毒來設計疫苗，理論上所產生的抗體數量及濃度亦會為高，抵抗的效果亦會相對顯著，但ADE的機率出現亦會相對為高。802Please respect copyright.ＰＥＮＡＮＡfxLUyWCoRn
802Please respect copyright.ＰＥＮＡＮＡ856Dh7zHM2
802Please respect copyright.ＰＥＮＡＮＡYRbdR1Vgf8
美國Moderna已表示Phase3的報告將會探討ADE的可能，但願中國Sinovac及國營Sinopharm的Phase3報告，也會在ADE方面進行深入探討吧！802Please respect copyright.ＰＥＮＡＮＡMhBGP0Caym
802Please respect copyright.ＰＥＮＡＮＡtFI7SSY2HP
如果想我快啲出文的話，請入去Penana網站科普專欄–薯不揀單俾一個like以及Bookmark，這對我非常之重要。802Please respect copyright.ＰＥＮＡＮＡi5ZDc3Y5oN
802Please respect copyright.ＰＥＮＡＮＡpulJ2lkhhF
Link: https://www.penana.com/story/66244/%E7%A7%91%E6%99%AE%E5%B0%88%E6%AC%84-%E8%96%AF%E4%B8%8D%E6%8F%80%E5%96%AE/toc802Please respect copyright.ＰＥＮＡＮＡxrWzcI3gSv
802Please respect copyright.ＰＥＮＡＮＡWM7aQGCqoW
同時亦可以在Penana網站裡按「買一嚿/半嚿薯仔」，以課金的方式推動我繼續搜羅資料寫文，多謝。802Please respect copyright.ＰＥＮＡＮＡJKGfSjqVP2
802Please respect copyright.ＰＥＮＡＮＡxcAuqeDx8z
Link:802Please respect copyright.ＰＥＮＡＮＡEYJOdUbO6o
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio802Please respect copyright.ＰＥＮＡＮＡ9zk8i3nmvB
802Please respect copyright.ＰＥＮＡＮＡnicDtOE3kw
802Please respect copyright.ＰＥＮＡＮＡFqaskTa3tC
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。802Please respect copyright.ＰＥＮＡＮＡugJCeCcBhg
802Please respect copyright.ＰＥＮＡＮＡY63XH0K7cR
802Please respect copyright.ＰＥＮＡＮＡ2ZRsKfcAll
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E802Please respect copyright.ＰＥＮＡＮＡuSg8uvGwHA
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4802Please respect copyright.ＰＥＮＡＮＡipKSDyxiQu
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf802Please respect copyright.ＰＥＮＡＮＡHBIano2y6x
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/802Please respect copyright.ＰＥＮＡＮＡBuIfJYRJHu
8964 copyright protection798ＰＥＮＡＮＡCD1uFWpZfH 維尼

3.22.248.193